■患有进行性慢性肾脏疾病(CKD)的患者发生心脏可植入电子设备(CIED)感染和并发症的风险更高。在具有主要或次要预防指征的患者中,植入式心脏除颤器(ICD)可以预防心脏猝死(SCD).我们回顾性比较了经静脉ICD(TV-ICD)和肌间植入皮下ICD(S-ICD)相关的感染和并发症发生率以及4期肾脏疾病受者的住院率。
■我们回顾性分析了来自六个德国中心的70例CKD4期患者,这些患者接受了带有单个右心室导线的预防性TV-ICD,49名患者,或者S-ICD,21名患者。随访(FU)每两年进行一次。
■TV-ICD患者明显年龄较大。与S-ICD组相比,该组有更多有房性心律失常病史的患者,并且处方抗心律失常药物的患者更多。其他基线特征没有显著差异。FU持续时间的中位数和四分位数范围为55.2(57.6-69.3)个月。FU期间,使用TV-ICD系统的患者经历了更多的设备相关感染(n=8,16.3%vs.n=0;p<0.05),装置相关并发症(n=13,26.5%vs.n=1,4.8%;p<0.05)和与设备相关的住院率(n=10,20.4%vs.n=1,4.8%;p<0.05)。
■在患有4期CKD且有预防性ICD适应症的患者的长期FU中,S-ICD与明显较少的器械相关感染相关,与TV-ICD相比,并发症和住院情况。
UNASSIGNED: Patients with progressive chronic kidney disease (CKD) are at higher risk of infections and complications from cardiac implantable electronic devices (CIED). In patients with a primary or secondary prophylactic indication, implantable cardiac defibrillators (ICD) can prevent sudden cardiac deaths (SCD). We retrospectively compared transvenous-ICD (TV-ICD) and intermuscularly implanted subcutaneous-ICD (S-ICD) associated infections and complication rates together with hospitalizations in recipients with stage 4 kidney disease.
UNASSIGNED: We retrospectively analyzed 70 patients from six German centers with stage 4 CKD who received either a prophylactic TV-ICD with a single right ventricular lead, 49 patients, or a S-ICD, 21 patients. Follow-Ups (FU) were performed bi-annually.
UNASSIGNED: The TV-ICD patients were significantly older. This group had more patients with a history of atrial arrhythmias and more were prescribed anti-arrhythmic medication compared with the S-ICD group. There were no significant differences for other baseline characteristics. The median and interquartile range of FU durations were 55.2 (57.6-69.3) months. During FU, patients with a TV-ICD system experienced significantly more device associated infections (n = 8, 16.3% vs. n = 0; p < 0.05), device-associated complications (n = 13, 26.5% vs. n = 1, 4.8%; p < 0.05) and device associated hospitalizations (n = 10, 20.4% vs. n = 1, 4.8%; p < 0.05).
UNASSIGNED: In this long-term FU of patients with stage 4 CKD and an indication for a prophylactic ICD, the S-ICD was associated with significantly fewer device associated infections, complications and hospitalizations compared with TV-ICDs.